Staffing a doctor's office during COVID-19

Continuing the discussion from The Nahployment 'Crisis':

We have had our short-staffed sign up for six months. Lack of staff is adversely affecting patient care. This translates to wait times upwards of twenty, sometimes forty minutes for walk-in patients (only seeing the physician gets a scheduled appointment, other services are walk-in). Multiple patients have derided management to my face, perhaps unaware that I am management just covering the desk. We have fired three patients who lost their temper and cursed out staff.


We have essentially had two full-time openings for four months (!). This is an office that normally employs five full-time employees, and three part-time.

Since March I personally called no less than three hundred applicants. Roughly eighty interviews made it onto our schedule. Fifteen showed up.

Seven were viable candidates, by which I mean they are okay with the description, hours, and benefits. Of those seven we offered to hire six (one no-showed the first interview and we offered someone else the job that afternoon). Not at once you see, when we make the offer we then have to wait two weeks for them to give notice.

Of the six who took the offer, two showed up for their first day. Both were emailed employment contracts beforehand.

Of the two who showed up for the first day, one never returned after the lunch break. She didn’t return my calls. There was no indication why - we were concerned she may have gotten into a car accident or something. That night she texted me that the hours (as written on her signed contract and emailed to her weeks ago) were unacceptable.

The second hire we had waited three weeks for her house to close, because we were (are) desperate. She gave it her all for training week and decided she didn’t like this kind of job after all. Very politely, she quit on Monday morning, effective… immediately. We were forced to cancel all of our patients for that day due to lack of staff.


We ended up re-hiring an ex-employee who had resigned years ago for personal reasons. She had been back for five days… then on Tuesday a family member she had seen over the weekend tested positive for COVID-19. This employee is now home self-isolating.


We have some patients who are nurses at other doctor’s offices. I have overheard them talking about staff shortages at their offices, ‘if Dr. X doesn’t hire somebody soon, I’m quitting. There’s only one of me.’

My employees are at their limit. I know it, they tell me. Even patients tell me. The employee that resigned in January was moving away, but the one that resigned in March almost certainly did so because she was overstressed by the staff shortage.

One thing we ask applicants who are currently employed is, why are you leaving your current job? I have noticed people are now writing, “staffing issues”.


To replace the employee who quit on Monday we are now trying to hire that seventh interviewee, who had no-showed her first interview. She has since taken another job, but doesn’t like it there. This afternoon she decided she would rather work for us after all. I asked her when she could start, and she told me next Monday…

~Max

What position are you hiring for? Part of my job brings me in and out of a lot of doctors offices…well, a lot consider I have nothing to do with medicine. But pre-pandemic, I was probably in a doctor’s office once a day, now it’s once or twice a week. I end up chit chatting with a lot of nurses and office managers during that time.
One thing I’ve learned is that a lot of office managers and other people that don’t need face time with patients can, and do, work from home. In fact, over the past year or so, the majority of my confirmations calls (as a patient, nothing to do with work) are coming from personal cell phones because they’re doing all the scheduling at home.

In any case, depending on what you’re looking for and how many hours they need to put in, if it’s all possible for them to work from home, maybe that’s an option. For example, if someone could do their job in, say, 2-3 hours a day from home, they could do it without quitting their current job.
OTOH, if you’re looking to hire another provider, that’s different.

My other suggestion would be to talk to people that are in and out of other offices. If you’re in an office that gets visits from drug reps, ask them how other offices are handling this situation. Half their job is talking to office staff and they pick up a lot that way.

And I had been working from home, until I was needed to cover the desk. The positions we are out of are patient-facing clinical staff. It’s at the point where if one person calls in sick or something, we have to cancel patients for the day (as happened on Monday).

And yeah, we just started seeing reps again last month.

~Max

Are you offering telemedicine? Two of my docs (GP and allergist) both do virtual/phone visits. I only talk to the doc, no nurse (no vitals/backstory etc) and the whole thing takes about 5-10 minutes.

The reps we work with have been doing virtual visits since the beginning, a few of them have started going back to in-person visits, but not many and only to the independent offices (I’m guessing you’re not affiliated with a group). The offices that are part of bigger groups aren’t doing it and, I suspect, most, if not all, will use this to as a way to put a policy in place to stop drug rep-provided lunches. A lot of them already had (years earlier) and the remaining ones had begun moving in that direction, pre-covid.

The other thought I had, and I’m just tossing it out there since it’s likely not feasible, especially since this is, hopefully, going to end sooner rather than later, is finding another office and somehow teaming up with them.
My allergist has two or three locations and they’ve started shuffling staff to where they’re needed, but they’re all still working for the same provider/employer. I’m curious if it could work with an unrelated office. If you’re short, you can have access to their staff, if they’re short, they can borrow someone from your staff.

But, yeah, pick your drug-rep’s brains. They’ll be more than happy to tell you what other places are doing. Remember, the less overworked your staff is, the more likely you are to let them come in for meetings/lunches.

We offer telemedicine, but it has spun down considerably since January as everyone got their vaccines. A lot of the services in our specialty require physical presence, for example to use the machine or for us to perform a test.

Ahahaha, as a small one-doctor practice it is the complete opposite here. Our doc reminisces to when the reps would fly him across the country and buy him $1,000 wines and steak dinners.

~Max

That was a long, long time ago. When we first got into it, the ‘trip to Pebble Beach, a Corvette will be waiting for you at the airport, condo is fully stocked with booze/food for the week and you have a tee-time at 10 on Tuesday, Wednesday and Friday’ was just winding down. Reps were allowed to take the entire office, and spouses to restaurant dinners with a $100+/person budget. Now they get something closer to $25ish per person catered lunch, in office. In some cases, the headcount can only include doctors, PAs (RPNs?). Basically the people that can write prescriptions. So an office of 20, might give the rep a budget of $200. Luckily, that’s within our wheelhouse. And, if a doc or two isn’t there to sign the sheet, it can be a real headache.
Your doc has been practicing since at least the late 90’s, right?